| NPI | 1568272045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS045428) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 42024) |
| 122300000X Dentist (Licence: NJ 22DI03122100) | |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-10-01 |