| NPI | 1780179556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 38849) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 38849) |
| 1223G0001X Dentist, General Practice (Licence: LA 6893) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 6893) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-08-08 |