| NPI | 1518262054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26359) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59773) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2019-10-24 |