| NPI | 1952374274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 11449) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 17992) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2007-07-08 |