| NPI | 1669534848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 38146) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 41132) |
| 1223G0001X Dentist, General Practice (Licence: TX 38146) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2026-02-04 |