| NPI | 1841505955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DJ02407800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038479) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-09-23 |