| NPI | 1801323134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38157) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61720) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-06-23 |