| NPI | 1467513283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D102346700) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS036906) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-03-03 |