| NPI | 1023325958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 14582) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14582) |
| 1223G0001X Dentist General Practice (Licence: DC DEN1001064) | |
| 1223G0001X Dentist General Practice (Licence: VA 0401412954) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2014-06-12 |