| NPI | 1447506019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413683) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001141) |
| 122300000X Dentist (Licence: MD 15158) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |