| NPI | 1225414907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN21596) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041122) |
| 122300000X Dentist (Licence: WV 4182) | |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2021-07-09 |