| NPI | 1679704290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 14397) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1000799) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2020-03-14 |