| NPI | 1306948914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS030864L) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 19989) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2018-11-08 |