| NPI | 1922252915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 30925) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN18497) |
| 1223G0001X Dentist General Practice (Licence: CA 63308) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2016-01-15 |