| NPI | 1629045950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28427) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000008257) |
| 1223G0001X Dentist, General Practice (Licence: KS 60289) | |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2023-08-10 |