| NPI | 1578122461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS-042252) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA 00000000000) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-03-18 |