| NPI | 1740088871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS044981) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS044981) |
| 122300000X Dentist (Licence: NJ 22DI02963900) | |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-06-26 |