| NPI | 1902938046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 23838) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 0023838) |
| 122300000X Dentist (Licence: CA 53206) | |
| 1223G0001X Dentist, General Practice (Licence: CA D53206) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2009-09-16 |