| NPI | 1972826378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN24623) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038143) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2020-02-05 |