| NPI | 1770798456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS035784) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS035784) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-10-27 |