| NPI | 1699028258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039206) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02516700) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2024-09-24 |