| NPI | 1730463142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS038791) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA DDS101378) |
| 1223G0001X Dentist General Practice (Licence: PA DS038701) | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2017-11-30 |