| NPI | 1225413511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI02608300) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040391) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |