| NPI | 1417268038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 41208) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 056505) |
| 122300000X Dentist (Licence: NC 9222) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2025-02-19 |