| NPI | 1215484845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 35542) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 35542) |
| 122300000X Dentist (Licence: CA DDS100394) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2025-03-04 |