| NPI | 1891983532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 24918) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14193) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2019-03-19 |