| NPI | 1619618675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41140) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 17520) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-06-03 |