| NPI | 1710301114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001347) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414312) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2014-02-06 |