| NPI | 1174294052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS043388) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 063637) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2023-11-14 |