| NPI | 1063697175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 23426) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 0023426) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2011-07-05 |