| NPI | 1629575618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042435) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD DS042435) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2020-01-08 |