| NPI | 1578698015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14360) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14360) |
| 1223G0001X Dentist, General Practice (Licence: PA 035407) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2022-01-12 |