| NPI | 1528290186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9942) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 107061) |
| 122300000X Dentist (Licence: NM DD3262) | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2016-12-13 |