| NPI | 1124254149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16091) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038453) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2016-01-13 |