| NPI | 1851829030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34453) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: LA 6759) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2020-08-28 |