| NPI | 1043771447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS041574) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA DS041574) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2020-06-25 |