| NPI | 1922418144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33655) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20409) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2022-01-05 |