| NPI | 1851654388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039402) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010862) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2016-05-25 |