| NPI | 1225393838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS039233) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039233) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-09-01 |