| NPI | 1710175740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23751) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56387) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2008-05-20 |