| NPI | 1174609333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10949) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-05-14 |