| NPI | 1760659601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS037385) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037385) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2012-07-31 |