| NPI | 1174366520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41869) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2024022477) |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2026-09-04 |