| NPI | 1396388294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37069) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7284) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2022-07-18 |