| NPI | 1023216496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411878) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001167) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2012-10-29 |