| NPI | 1952894461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34226) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 61740) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-11-09 |