| NPI | 1982959854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28103) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 28103) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 28103) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-07-21 |