| NPI | 1396716486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 17871) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS041278) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22D102297800) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2024-06-20 |