| NPI | 1649358920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ D117730) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS028081L) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-03-03 |