| NPI | 1326384041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI02527500) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039378) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2021-05-20 |