| NPI | 1952095861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 220103007800) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS044130) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2024-01-16 |