| NPI | 1801035159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 102351) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 6999-244-9922) |
| 122300000X Dentist (Licence: CO 9851) | |
| 1223G0001X Dentist, General Practice (Licence: OH 30. 023122) | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2018-04-24 |