| NPI | 1609668672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS045195) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03091400) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-06-16 |