| NPI | 1801866793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS036217) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA ds036217) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-12-15 |