| NPI | 1871154773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 35298) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 35298) |
| Enumeration Date | 2019-06-22 |
| Last Update Date | 2022-12-17 |