| 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 | 2025-05-14 |