| NPI | 1205287984 |
|---|---|
| Former Name | ALICIA YIM DARAWSHEH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415456) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16220) |
| 1223G0001X Dentist, General Practice (Licence: PA DS040896) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2024-07-11 |