| NPI | 1235383357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3822) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037687) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2021-04-09 |