| NPI | 1083848964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS038057) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DE G10001291) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2010-08-18 |