| NPI | 1932496056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS038975) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CT 010557) |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2014-08-03 |