| NPI | 1861450728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN20269) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7781) |
| 122300000X Dentist (Licence: PA DSO83211) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-11-12 |