| NPI | 1619279577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14822) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8880) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2023-06-07 |