| NPI | 1356570998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV S6-118) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI L1596214) |
| 122300000X Dentist (Licence: TX 28621) | |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2016-12-15 |