| NPI | 1760161079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA RFD000085) |
| Additional Taxonomies | 125Q00000X Oral Medicine (Licence: PA RFD000085) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2026-08-17 |