| NPI | 1649646837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042824) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 13745) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.030443) | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2020-09-16 |