| NPI | 1154981561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 2.012553) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042181) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02760200) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2021-02-01 |