| NPI | 1922793132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 42244) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2025024478) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2026-06-03 |