| NPI | 1114410255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 34031) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 34031) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-08-24 |