| NPI | 1114176005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13892) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 2216) |
| 122300000X Dentist (Licence: PA DS-031485-L) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-16 |