NPI | 1265512081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA 020001-L) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS020001L) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2016-05-23 |