| NPI | 1083080261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS040496) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040496) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2023-03-02 |