| NPI | 1992069595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29426) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61411) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2017-04-13 |