| NPI | 1609446830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL dn26569) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS043176) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2024-11-14 |