| NPI | 1174806087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS038784) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02890900) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2024-05-13 |