| NPI | 1609438597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001978) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416431) |
| 1223G0001X Dentist, General Practice (Licence: MD 16803) | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2023-09-29 |