| NPI | 1851604557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 038490) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 24441) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2011-12-09 |