| NPI | 1396240123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35996) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6950) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2022-09-08 |