| NPI | 1235667528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16772) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041287) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-12-02 |