| NPI | 1831486331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 29469) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN 19771) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2022-07-23 |