| NPI | 1760517189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37950) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54853) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2021-11-10 |