NPI | 1891195087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02577500) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040165) |
Enumeration Date | 2014-08-26 |
Last Update Date | 2015-12-21 |