| NPI | 1215457114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 38076) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 122987) |
| 1223G0001X Dentist, General Practice (Licence: OR D11209) | |
| 1223G0001X Dentist, General Practice (Licence: TX 38076) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-09-04 |