| NPI | 1326539230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 13587) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857922) |
| 122300000X Dentist (Licence: PA DS042889) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2024-05-24 |