| NPI | 1215262712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58998) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 24771) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2019-07-26 |