| NPI | 1518686898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044072) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS044072) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2024-04-09 |