| NPI | 1073242178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41165) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7327) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-01-30 |