| NPI | 1669614764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25221) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 57530) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2010-05-14 |