| NPI | 1366187726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DB-2024-0019) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 38425) |
| Enumeration Date | 2022-04-30 |
| Last Update Date | 2024-03-27 |