| NPI | 1619255395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15091) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038800) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2018-06-13 |