| NPI | 1063534105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 60883) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 14808) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |