| NPI | 1720424963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS039524) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039524) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2019-07-08 |