| NPI | 1992567192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 40421) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 40421) |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-01-24 |