| NPI | 1962020982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38166) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 11516) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2022-03-21 |