| NPI | 1013050426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1000225) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 12956) |
| 122300000X Dentist (Licence: VA 0401411944) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2011-02-01 |