| NPI | 1407464423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS042707) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 16960) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |