| NPI | 1992800171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58947) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21401) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2010-11-22 |