| NPI | 1992205777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD4732) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 33194) |
| Enumeration Date | 2018-02-18 |
| Last Update Date | 2024-10-01 |