| NPI | 1013247162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS037653) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02422500) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |