| NPI | 1518245604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 62040) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038804) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2020-10-12 |