| NPI | 1699072892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16614) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 107082) |
| 122300000X Dentist (Licence: PA DS038418) | |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2024-09-04 |