| NPI | 1033601802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34873) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041704) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2020-08-08 |