| NPI | 1376776229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 10384) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037872) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2011-11-09 |