| NPI | 1295836591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 33103) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 13794) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-07-21 |