| NPI | 1255825527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33730) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 33730) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2025-04-20 |