| NPI | 1598134033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS040599) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02617500) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2022-05-26 |