| NPI | 1447571245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 10210) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014713) |
| 122300000X Dentist (Licence: NM DD3844) | |
| 122300000X Dentist (Licence: UT 8501554-8903) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2014-01-13 |