| NPI | 1598881195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 35942) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4609) |
| 1223G0001X Dentist, General Practice (Licence: PA 037584) | |
| 1223G0001X Dentist, General Practice (Licence: TX 35942) | |
| 1223G0001X Dentist, General Practice (Licence: NY 038765) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2023-04-03 |