| NPI | 1902491673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 41546) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist Speech-Language Assistant (Licence: TX 41667) |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2025-07-22 |