| NPI | 1386100139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 14564) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 9843) |
| 122300000X Dentist (Licence: PA DS042871) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: SC DGD10010) | |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2026-03-11 |