| NPI | 1912436874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042918) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY Unknown) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 00203918) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2020-09-16 |