| NPI | 1427492099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 28723) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DENT.DE.70042796) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2026-07-30 |