| NPI | 1821222696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 14439) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: VA 0401412448) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2021-10-19 |