| NPI | 1942465323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS036030) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ DI022488) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2019-10-24 |