| NPI | 1518454859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044420) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI03005800) |
| 1223G0001X Dentist, General Practice (Licence: NY 060696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2026-03-03 |