| NPI | 1821021890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24392) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 45959) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-01-06 |