| NPI | 1003061300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13680) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1000549) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |