| NPI | 1255778247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37996) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 8668332) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2021-12-22 |