| NPI | 1699085035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02853300) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS031518L) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2021-08-25 |