| NPI | 1619130085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WV 3827) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037979) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2014-03-20 |