| NPI | 1740679455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001446) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15674) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2019-11-27 |