| NPI | 1689297327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS042792) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 38996) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2022-09-13 |