| NPI | 1710378716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16397) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 04041415806) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2021-08-09 |