| NPI | 1861780389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 203942) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 27251) |
| 1223G0001X Dentist General Practice (Licence: CA 65284) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2025-09-03 |