| NPI | 1679027205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39300) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS04812) |
| 122300000X Dentist (Licence: PA ds040812) | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-04-05 |