| NPI | 1982658233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60209) |
| 1223G0001X Dentist, General Practice (Licence: MO 2003011299) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-03-02 |