| NPI | 1972081032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37013) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041905) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-10-15 |