| NPI | 1245526870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6413) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9458) |
| 1223D0001X Dentist, Dental Public Health (Licence: TX 28757) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA S-711) | |
| 1223G0001X Dentist, General Practice (Licence: TX 28757) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2019-02-22 |