| NPI | 1922269141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25075) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22193) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2009-12-18 |