| NPI | 1659536282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-09721) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054176) |
| 122300000X Dentist (Licence: AZ D7763) | |
| 122300000X Dentist (Licence: CA 57263) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2020-03-13 |