| NPI | 1134409402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02503500) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039053) |
| 1223G0001X Dentist, General Practice (Licence: CT 010870) | |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2024-12-29 |