| NPI | 1295196962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DA031802) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040677) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2018-09-05 |