| NPI | 1841578085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31707) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15151) |
| 1223G0001X Dentist, General Practice (Licence: PA DS038823) | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2020-12-17 |