| NPI | 1568100881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS043577) | 
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS043577) | 
| Enumeration Date | 2022-05-25 | 
| Last Update Date | 2022-05-25 |