| NPI | 1194932095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS041151) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: WI 5001949) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2019-10-28 |