| NPI | 1770849796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD3884) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: NM DD3884) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2013-09-19 |