| NPI | 1922501121 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: TX 37953) | 
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NE 7859) | 
| Enumeration Date | 2018-03-14 | 
| Last Update Date | 2024-02-11 |