| NPI | 1013494939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS041872) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041872) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2022-11-29 |