| NPI | 1760910657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34749) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001706-15) |
| 122300000X Dentist (Licence: UT 10457477-9921) | |
| 122300000X Dentist (Licence: CO DEN.00203335) | |
| 122300000X Dentist (Licence: IL 019.031433) | |
| 122300000X Dentist (Licence: PA DS041484) | |
| 122300000X Dentist (Licence: CA 102361) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2019-01-26 |