| 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 |