NPI | 1831650233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS043908) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02847400) |
Enumeration Date | 2019-03-28 |
Last Update Date | 2023-09-12 |