| NPI | 1902211899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 18187) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 38067) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2024-10-09 |