| NPI | 1659850139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02725800) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042697) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2021-01-21 |