| NPI | 1144585415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16029) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 742) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2015-07-15 |