| NPI | 1417341983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10191) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33934) |
| 122300000X Dentist (Licence: WA DE60540896) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-11-17 |