| NPI | 1154606309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22di02450200) |
| Additional Taxonomies | 122300000X Dentist (Licence: DE G1-0001431) |
| 122300000X Dentist (Licence: PA DN002164) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2019-07-15 |