| NPI | 1861848913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 31925) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 20825) |
| Enumeration Date | 2016-05-08 |
| Last Update Date | 2017-01-18 |