| NPI | 1699269522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN123608) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042041) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02794900) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2025-09-22 |