| NPI | 1922416494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 30228) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30228) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2016-09-12 |