| NPI | 1225309362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001234) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15003) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2018-03-17 |