| NPI | 1174816367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22di02472000) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA ds038633) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2013-02-27 |