| NPI | 1750568770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS036995) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02328100) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2014-01-06 |