| NPI | 1750518445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039389) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054284) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2024-09-04 |