| NPI | 1932308673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23460) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037279) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2012-05-22 |