| NPI | 1871742536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23531) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 23531) |
| 1223G0001X Dentist, General Practice (Licence: AZ 7649) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2015-10-13 |