| NPI | 1548765027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16749) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001970) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2019-07-01 |