| NPI | 1003844770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DEFC.DF.60476251) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM TD0014) |
| 122300000X Dentist (Licence: NM DD3166) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2014-07-08 |