| NPI | 1609204874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02551100) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS043454) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2022-03-21 |