| NPI | 1508036682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS028857L) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI01889900) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2022-11-10 |