| NPI | 1457686297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40055) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6015) |
| 1223G0001X Dentist, General Practice (Licence: SC 7115) | |
| 1223G0001X Dentist, General Practice (Licence: VA 00401412800) | |
| 122300000X Dentist (Licence: IL 019.03.1973) | |
| 122300000X Dentist (Licence: KS 61589) | |
| 122300000X Dentist (Licence: GA DN014009) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2024-04-17 |