| NPI | 1396262317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI02688800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042858) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-10-03 |