| NPI | 1134771587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39225) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 103733) |
| 122300000X Dentist (Licence: TX 39225) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2026-03-12 |