NPI | 1902543101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS045077) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401418794) |
Enumeration Date | 2022-05-18 |
Last Update Date | 2025-10-08 |