| NPI | 1134322365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS037168) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037168) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2016-01-18 |