| NPI | 1598861924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29296) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54695) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2014-06-30 |