| NPI | 1316296940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 15180) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS039201) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2022-07-29 |