| NPI | 1538729009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35146) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 7186) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-21 |