| NPI | 1831541614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16036) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001826) |
| 122300000X Dentist (Licence: VA 0401416621) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2021-09-24 |