| NPI | 1609533850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37923) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 108716) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2023-05-08 |