| NPI | 1588073027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 11644) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6172) |
| 122300000X Dentist (Licence: GA DN014827) | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2019-11-11 |