| NPI | 1205901147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS031207L) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 5521015) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2017-03-21 |