| NPI | 1932638160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33825) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022247) |
| 122300000X Dentist (Licence: TX 33825) | |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2025-07-06 |