| NPI | 1811553670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044831) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061262) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2024-12-11 |