| NPI | 1083928782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS038393) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038393) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2019-02-14 |