| NPI | 1417927377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 21322) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 0021322) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-03-15 |