| NPI | 1346487659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28704) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56432) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2018-11-04 |