| NPI | 1861834830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 35720) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53234) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2021-02-24 |