| NPI | 1174907224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicinist (Licence: PA RFD000056) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA RFD000056) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2023-03-24 |