| NPI | 1396934642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS019118L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS019118L) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |