| NPI | 1669735841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS039933) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6214) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-12-29 |