| NPI | 1487819074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24907) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 150691) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2017-03-02 |