| NPI | 1134808959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS044424) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02908700) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2024-07-15 |