| NPI | 1588135420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38037) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7042) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2024-06-03 |