| NPI | 1801101407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS045407) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08745) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2025-09-05 |