| NPI | 1457649394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE GI-0000990) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS-022820L) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-07-13 |