| NPI | 1750479069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23714) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD2775) |
| 1223G0001X Dentist, General Practice (Licence: NY 041388) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-12-27 |