| NPI | 1114281490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE G1-0001333) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038828) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2016-11-17 |