| NPI | 1437171972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 8346) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 10289) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-02-18 |