| NPI | 1023424884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15780) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001406) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2019-02-21 |