| NPI | 1700262748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 36752) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 64737) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2024-07-18 |