NPI | 1962896647 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS040720) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02637200) |
Enumeration Date | 2015-03-20 |
Last Update Date | 2024-06-20 |