| NPI | 1891474391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41329) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA S48628806) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2026-06-09 |