| NPI | 1538494638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28697) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 58587) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2013-10-17 |