| NPI | 1497948343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1000690) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14189) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2015-04-09 |