| NPI | 1619424520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02730400) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041046) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2022-07-13 |