| NPI | 1558781393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-4990-PD) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040704) |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2024-03-14 |