| NPI | 1740313105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037786) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 3663) |
| 1223G0001X Dentist, General Practice (Licence: OH 30.021901) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-10-22 |