| NPI | 1801104427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 26371) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038488) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2016-10-10 |