| NPI | 1124419007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA DDS65045) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 30577) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2020-06-16 |