| NPI | 1225481393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31986) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 39186) | 
| Enumeration Date | 2016-07-13 | 
| Last Update Date | 2021-09-01 |