| NPI | 1962446195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22028) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 22028) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 22028) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2024-06-12 |