| NPI | 1952464182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13928) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: DC DEN10000423) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-08-30 |