| NPI | 1326590365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001723) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC den1001723) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2023-03-09 |