| NPI | 1144451592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37968) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58580) |
| 1223G0001X Dentist, General Practice (Licence: NV 5806) | |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2022-07-26 |