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 |