| NPI | 1255648606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26075) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59724) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2018-04-23 |