| NPI | 1528290426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 24664) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 24664) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2024-06-26 |