| NPI | 1407690506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI03104600) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS045205) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-06-30 |