| NPI | 1174045066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE G1-0001420) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041445) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2018-07-26 |