| NPI | 1841603990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS041646) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 057927) |
| 1223G0001X Dentist, General Practice (Licence: PA DS041646) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2021-06-29 |