| NPI | 1942941851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS044976) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS044976) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-07-11 |