| NPI | 1376682138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME DEN4156) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT 2254) |
| 122300000X Dentist (Licence: OH 300322286) | |
| 122300000X Dentist (Licence: MD 13862) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-09 |