| NPI | 1932830767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 42048) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 7298) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2026-06-04 |