| NPI | 1710112016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3437) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS030930L) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2010-06-24 |