| NPI | 1720488927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15700) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414637) |
| 122300000X Dentist (Licence: DC DEN1001441) | |
| 1223G0001X Dentist, General Practice (Licence: VA 0401414637) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2020-10-05 |