| NPI | 1942791868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 36662) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 36662) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2021-08-28 |