| NPI | 1164041703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 37730) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD LL868) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-02-20 |