| NPI | 1386362606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39435) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11654) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2025-11-19 |