| NPI | 1548278377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: KY 10148) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10148) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-01-29 |