| NPI | 1669569174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7967) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9277) |
| 1223D0001X Dentist, Dental Public Health (Licence: NC 7967) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-02-10 |