| NPI | 1306076393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-09359) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6814) |
| 122300000X Dentist (Licence: MO 2016031853) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2020-01-23 |