| NPI | 1073095030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS043477) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 4342) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2022-04-05 |