NPI | 1588044143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS040407) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040407) |
Enumeration Date | 2015-06-08 |
Last Update Date | 2023-02-13 |