| NPI | 1174131320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS044925) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 18451) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2025-04-22 |