| NPI | 1669710570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38277) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413926) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2026-01-15 |