| NPI | 1962486837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS043448) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 48415) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2024-02-27 |