| NPI | 1184862369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15095) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: DC DEN1001371) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2014-09-24 |