| NPI | 1861013492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS043348) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DRPM2209) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2024-08-27 |