| NPI | 1841555240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 38404) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039240) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2022-07-28 |