| NPI | 1811109127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NV S4-119C) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 15465) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-07-26 |