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 |