| NPI | 1013452994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 32501) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 32501) |
| 1223E0200X Dentist, Endodontics (Licence: TX 32501) | |
| 1223G0001X Dentist, General Practice (Licence: TX 32501) | |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2024-05-30 |