| NPI | 1720265804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21451) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 8143) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2026-05-27 |