| NPI | 1306106091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14904) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039071) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2018-03-13 |