| NPI | 1629599774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN24037) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041675) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2021-12-16 |