| NPI | 1649591314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS038205) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02464700) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2020-12-11 |