| NPI | 1407364458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS041582) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL13670) |
| 122300000X Dentist (Licence: PA DS041582) | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2024-08-27 |