| NPI | 1689002289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 62657) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 29457) |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2015-03-12 |