NPI | 1235786385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS041981) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041981) |
1223G0001X Dentist, General Practice (Licence: NJ 22DI02728600) | |
Enumeration Date | 2019-08-23 |
Last Update Date | 2022-06-28 |