| NPI | 1922149293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OR D11024) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: KY 8151) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2024-03-13 |