| NPI | 1598487621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41242) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859584) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2025-03-25 |