| NPI | 1659447001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22364) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21598) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 21598) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS037419) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-12-07 |