| NPI | 1124432349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32631) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 10960) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-06-17 |