| NPI | 1083102669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042585) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042585) |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2020-06-29 |