| NPI | 1891840161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13152) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 17685) |
| 1223G0001X Dentist, General Practice (Licence: KY 1152) | |
| 1223G0001X Dentist, General Practice (Licence: VA 040106113) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |