| NPI | 1558695569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 27705) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE 00010840) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2012-06-28 |