| NPI | 1992291017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34936) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN23475) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2019-06-23 |