| NPI | 1518111467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 22814) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN28702) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2025-07-30 |