| NPI | 1134476153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 99) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60300514) |
| 122300000X Dentist (Licence: VA 0401414713) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2023-08-30 |