| NPI | 1932162427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26151) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D4987) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2011-07-13 |