| NPI | 1306869664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9850) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 18903) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-11-05 |