| NPI | 1225471311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29158) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61353) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-07-11 |