| NPI | 1194905646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1000959) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401410898) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2011-10-22 |