| NPI | 1033598040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS040350) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001530) |
| 122300000X Dentist (Licence: MD 16045) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2018-11-08 |