| NPI | 1215080197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037390) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21700) |
| 1223G0001X Dentist, General Practice (Licence: NY 052436) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-11-05 |