| NPI | 1528411444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 7292) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61343) |
| 122300000X Dentist (Licence: OK RES-1326) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2019-08-21 |