| NPI | 1528473394 |
|---|---|
| Former Name | MARLA MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN23065) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021305) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2018-03-17 |