NPI | 1275169849 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16930) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS041943) |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS041943) | |
Enumeration Date | 2020-03-16 |
Last Update Date | 2020-07-02 |