| NPI | 1295972115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ DI02529800) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037622) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2021-11-16 |