| NPI | 1295967438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13479) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC Den1000362) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2020-10-05 |