| NPI | 1912063090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 8003) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 46179) |
| 122300000X Dentist (Licence: AZ D08003) | |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2019-08-01 |