| NPI | 1841339603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 22593) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: LA 5494) |
| 1223G0001X Dentist General Practice (Licence: AZ 6828) | |
| 1223G0001X Dentist General Practice (Licence: GA DN013240) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-12-11 |