| NPI | 1376942573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 29922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 29922) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2021-08-16 |