| NPI | 1841558442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27772) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038969) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |