| NPI | 1851476089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN00009208) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61146) |
| 122300000X Dentist (Licence: WA DE60310664) | |
| 122400000X Denturist (Licence: NM DD3822) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-02-20 |