| NPI | 1922197821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24770) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051299) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-09-09 |