| NPI | 1881982320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS040636) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN 20718) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2017-01-10 |