| NPI | 1740554161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27709) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 60932) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-03-02 |