| NPI | 1992286595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 37366) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX ETN621) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2022-12-15 |