| NPI | 1740332022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9941) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413908) |
| 122300000X Dentist (Licence: CA 36002) | |
| 122300000X Dentist (Licence: MO mo2009037198) | |
| 122300000X Dentist (Licence: DC den1001321) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2015-06-14 |