| NPI | 1497131395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40406) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 64715) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2025-05-23 |