| NPI | 1881925550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS039510) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 10172) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2016-11-08 |