| NPI | 1447706601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS041032) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857357) |
| 122300000X Dentist (Licence: PA DS041032) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857357) | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2019-08-16 |