| NPI | 1316195738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS036332) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS036332) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2018-11-05 |