| NPI | 1972830289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 23607) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23607) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2015-12-07 |