| NPI | 1033773429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17311) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1002211) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2021-08-05 |