| NPI | 1508080813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: PA DS 027478 L) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS 027478 L) |
| 1223P0700X Dentist Prosthodontics (Licence: PA DS 027478 L) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2017-03-22 |