| NPI | 1912423377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 11571) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 11571) |
| 1223G0001X Dentist, General Practice (Licence: TX 33300) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2024-03-26 |