| NPI | 1124595517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34680) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7148) |
| 1223G0001X Dentist, General Practice (Licence: CA 103334) | |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2021-11-12 |