| NPI | 1720399561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 260130) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038906) |
| 1223G0001X Dentist, General Practice (Licence: MD 15027) | |
| Enumeration Date | 2010-06-26 |
| Last Update Date | 2016-10-03 |