| NPI | 1235247123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00007820) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4896) |
| 1223G0001X Dentist, General Practice (Licence: TX 25070) | |
| 1223G0001X Dentist, General Practice (Licence: KY 4270) | |
| 1223G0001X Dentist, General Practice (Licence: PA DS038128) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2015-11-12 |