| NPI | 1003292491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 31157) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL D-0006935-C) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2026-09-03 |