| NPI | 1083961460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE G1-0001351) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039102) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2018-06-12 |