| NPI | 1689807745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25137) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58680) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2019-08-15 |