| NPI | 1003115221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS038584) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02467800) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2019-01-08 |