| NPI | 1871747238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS037803) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052841) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2009-06-25 |