| NPI | 1730406166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25267) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 57412) |
| Enumeration Date | 2010-04-25 |
| Last Update Date | 2012-06-06 |