| NPI | 1023246303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI02423400) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037974) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2014-08-20 |