| NPI | 1255876017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN22252) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042006) |
| 122300000X Dentist (Licence: NJ 22DI02658100) | |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2022-11-16 |