| NPI | 1508396458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02704300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042607) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-11-27 |