| NPI | 1922447192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15537) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001302) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2020-10-01 |