| NPI | 1366873002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1002058) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15352) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401414060) | |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2019-11-17 |