| NPI | 1366721797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60453225) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 60652) |
| 122300000X Dentist (Licence: TX 27556) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2024-12-31 |