| NPI | 1215384383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 32156) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 32156) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2023-07-04 |