| NPI | 1821404138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS040271) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040271) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2016-11-21 |