| NPI | 1689839094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ D102485) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037466) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2012-08-21 |