| NPI | 1487723730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 24329) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TN 8349) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-01-19 |