| NPI | 1700012903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 0024597) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023645) |
| 122300000X Dentist (Licence: FL DN 21604) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2024-07-03 |