| NPI | 1912917873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32409) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN15797) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-12-08 |