| NPI | 1275096133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35450) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS104763) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2023-02-16 |