| NPI | 1548613086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16601) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001795) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2020-02-24 |