| NPI | 1245479666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1000789) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401412877) |
| 1223G0001X Dentist, General Practice (Licence: MD 14387) | |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2018-03-17 |