| NPI | 1083051445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02537500) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039472) |
| Enumeration Date | 2013-05-25 |
| Last Update Date | 2014-02-28 |