| NPI | 1376825653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS038883) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038883) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2016-03-23 |