| NPI | 1730671215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS043784) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 11014) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-01-06 |