| NPI | 1477970267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO DEN.00203855) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60561975) |
| 1223P0300X Dentist, Periodontics (Licence: MA DN1857192) | |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2019-10-25 |