| NPI | 1861849184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16729) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040904) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2021-01-04 |