| NPI | 1124206479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02022400) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS025752L) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2021-05-10 |