| NPI | 1659895753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40805) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101544) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2025-05-31 |