| NPI | 1548611510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN23730) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 32681) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX ETN421) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2021-07-13 |