| NPI | 1285878553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26244) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 546271768) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2011-02-02 |