| NPI | 1811205800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 35882) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D9507) |
| 122300000X Dentist (Licence: WA DE60169364) | |
| 122300000X Dentist (Licence: KS 60747) | |
| 122300000X Dentist (Licence: MO 2011008849) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2022-05-02 |