| NPI | 1487432746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39703) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7410) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-12-03 |