| NPI | 1386823912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24889) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 56361) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2017-10-09 |