| NPI | 1457612541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN DS0000009624) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: IL 019029250) | |
| 1223E0200X Dentist, Endodontics (Licence: TN DS0000009624) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS0000009624) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2016-07-28 |