| NPI | 1619497906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 62049) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00203230) |
| 122300000X Dentist (Licence: TX 34833) | |
| 122300000X Dentist (Licence: MO 2022044247) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2024-03-14 |