| NPI | 1841809290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D011178) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 36319) |
| 122300000X Dentist (Licence: CA 105979) | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2021-09-14 |