| NPI | 1316394687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 18350) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416526) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2024-11-25 |