| NPI | 1104155647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: TX 31822) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58986) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2017-02-02 |