| NPI | 1619258969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS038673) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038673) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02484700) | |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2024-12-04 |