| NPI | 1629427547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS040783) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02641600) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2019-11-21 |