| NPI | 1891009189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25709) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 10261) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2014-12-23 |