| NPI | 1629309794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10520) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DIO2431400) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401412865) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2021-04-29 |