| NPI | 1659784494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 32738) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9745) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-09-18 |