| NPI | 1366861452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039863) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15440) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |