| NPI | 1588046833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602059) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040486) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2024-10-18 |