| NPI | 1992068035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16738) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039077) |
| 1223G0001X Dentist, General Practice (Licence: MD 14876) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2024-04-03 |