| NPI | 1598147480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS041962) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 4169) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2025-03-19 |