| NPI | 1669964870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 31669) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 31669) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2020-10-21 |