| NPI | 1578867636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 26342) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI DEN03700) |
| 1223G0001X Dentist, General Practice (Licence: MA DN9500085) | |
| 1223G0001X Dentist, General Practice (Licence: CT 13942) | |
| 1223G0001X Dentist, General Practice (Licence: TX 26342) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2024-04-24 |