| NPI | 1801187240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60363) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 26056) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-06-14 |