| NPI | 1124477765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401416406) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC In process) |
| 122300000X Dentist (Licence: DC 101713) | |
| 122300000X Dentist (Licence: MD 16307) | |
| Enumeration Date | 2016-06-04 |
| Last Update Date | 2021-02-23 |