| NPI | 1972565794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 16345) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 16345) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-06-06 |