| NPI | 1295332591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 36593) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36593) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2025-09-10 |