| NPI | 1215125943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS036526) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13641) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |