| NPI | 1710850516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS045168) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA DS045168) |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-10-24 |