| NPI | 1851532568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00205889) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02401300) |
| 1223G0001X Dentist General Practice (Licence: CA DDS100984) | |
| 122300000X Dentist (Licence: PA DS039391) | |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2025-02-13 |