| NPI | 1225863608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40953) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 40953) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2025-04-16 |