| NPI | 1821417262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE G100011362) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040409) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2015-07-08 |