| NPI | 1013252378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 30584) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 2908) |
| 122300000X Dentist (Licence: TX 30584) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2023-10-02 |