| NPI | 1952698615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010451) |
| 1223G0001X Dentist, General Practice (Licence: NY 055644) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2015-07-29 |