| NPI | 1952533838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 14489) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 48491) |
| 122300000X Dentist (Licence: PA DS026029L) | |
| 122300000X Dentist (Licence: FL HAD 8) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2011-04-04 |