| NPI | 1609281062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 35934) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-024330) |
| 122300000X Dentist (Licence: TN 10714) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-09-21 |