| NPI | 1881752806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 11652) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS029470L) |
| 1223G0001X Dentist General Practice (Licence: PA DS029470L) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2024-10-01 |