| NPI | 1629093075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN14490) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS029147L) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-09-19 |