| NPI | 1619130572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN18601) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037528) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2012-01-03 |