| NPI | 1851065601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN26124) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-09-02 |