| NPI | 1164901542 |
|---|---|
| Former Name | AWBREY LANDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10882) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 13224) |
| 122300000X Dentist (Licence: SC DGD.10637) | |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2023-08-18 |