| NPI | 1720431315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02653300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040981) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-03-03 |