| NPI | 1730277633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS036833) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 150550) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |