| NPI | 1407271513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: PA DS040013) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040013) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2023-08-07 |