| NPI | 1083958847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS039148) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02514000) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02514001) | |
| Enumeration Date | 2012-11-18 |
| Last Update Date | 2015-05-20 |