| NPI | 1013220086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 31694) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60168215) |
| 122300000X Dentist (Licence: CA 59570) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2018-07-16 |