| NPI | 1306166319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 9352) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: KY 9352) | |
| 1223D0001X Dentist, Dental Public Health (Licence: KY 9352) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2014-07-10 |