| NPI | 1295980894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS037700) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD LL610) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02533300) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2019-01-10 |