| NPI | 1245544030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02530700) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS038330) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2013-05-23 |