| NPI | 1962678243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32351) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 2781) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2017-05-05 |