| NPI | 1548387822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34300) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 55409) |
| 122300000X Dentist (Licence: FL DN 17594) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2018-11-07 |