| NPI | 1669154472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D011948) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 109044) |
| 122300000X Dentist (Licence: TX 40132) | |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-11-01 |