| NPI | 1538313531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 922) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038248) |
| 122300000X Dentist (Licence: KY 8657) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2018-03-17 |