| NPI | 1922625813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37443) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 7311) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-07-13 |