| NPI | 1740541267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61329) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2013-05-30 |