| NPI | 1578719829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037592) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 7625) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02409100) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2012-04-05 |