| NPI | 1144555806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA D60951) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 024803) |
| 122300000X Dentist (Licence: PA DS038099) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2020-10-27 |