| NPI | 1740298371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13036) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1000990) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-04-04 |