| NPI | 1356848022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16835) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA Dn015756) |
| 122300000X Dentist (Licence: VA 0401416496) | |
| 122300000X Dentist (Licence: DC DEN1002080) | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-08-08 |