| 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 |