| NPI | 1811024581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22496) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55193) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2016-04-26 |