| NPI | 1487057535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30421) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63966) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2025-05-02 |