| NPI | 1730497249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 27675) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59423) |
| 122300000X Dentist (Licence: TX 27675) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 59423) | |
| 122300000X Dentist (Licence: AZ D008600) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AZ D008600) | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2016-01-20 |