| NPI | 1104057983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27436) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 27436) |
| 1223G0001X Dentist, General Practice (Licence: CA 58494) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2024-06-12 |