| NPI | 1710040340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS030795 L) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN15554) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-06-28 |