| NPI | 1144577735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS039281) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15242) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2018-11-19 |