| NPI | 1558821918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38322) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN24816) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-05-25 |