| NPI | 1871682948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 27634) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PR 2129) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-03-17 |