| NPI | 1235473018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 22443) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040107) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02508200) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2017-02-17 |