| NPI | 1598091167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 4665) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13812) |
| 122300000X Dentist (Licence: DC DEN1000593) | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2010-07-12 |