| NPI | 1811570658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS043509) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7714) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2022-06-23 |