| NPI | 1891104535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001574) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16113) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2016-05-20 |