| NPI | 1396153441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS042193) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014808) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2019-06-26 |