| NPI | 1871759621 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 29881) | 
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NC 11212) | 
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NY 057835) | |
| Enumeration Date | 2008-07-31 | 
| Last Update Date | 2025-01-08 |