| NPI | 1093225690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS041261) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041261) |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2021-03-31 |