| NPI | 1871957019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13100) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 32162) |
| 122300000X Dentist (Licence: NC 13100) | |
| 1223G0001X Dentist, General Practice (Licence: TX 32162) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2023-07-04 |