| NPI | 1700358041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042024) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042024) |
| 1223G0001X Dentist, General Practice (Licence: MA DL14824) | |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2022-07-01 |