| NPI | 1801938352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412424) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22D102242700) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-01-01 |