| NPI | 1982255436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35583) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042313) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |