| NPI | 1942321047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02257700) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS036169) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |