| NPI | 1972733533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25275) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY P78123) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2024-06-12 |