| NPI | 1912016924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS040542) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI019029) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-08-26 |