| NPI | 1073825980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40201) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 65176) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-06-17 |