| NPI | 1043498983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 27586) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5629) |
| 122300000X Dentist (Licence: CA 56275) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2015-02-18 |