| NPI | 1538370598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 22065) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS036276) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2010-05-06 |