| NPI | 1942352646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41206) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13355) |
| 1223G0001X Dentist, General Practice (Licence: CO DEN.00204914) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2025-08-22 |