| NPI | 1952005290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 206261) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 40576) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2025-06-22 |