| NPI | 1457580342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26137) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4639) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2011-02-18 |