| NPI | 1942576319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27808) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61193) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2016-06-06 |