| NPI | 1912063793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ D120769) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS030321L) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |