| NPI | 1346327269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410266) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13013) |
| 122300000X Dentist (Licence: DC DEN1000165) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-11-05 |