| NPI | 1669610440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: UT 319408-9924) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: OR D9011) |
| 124Q00000X Dental Hygienist (Licence: UT 3194089920) | |
| Enumeration Date | 2009-02-01 |
| Last Update Date | 2023-10-22 |