| NPI | 1932411667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 10133) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: TX 26422) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2019-01-09 |