| NPI | 1952734303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02547300) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039727) |
| 122300000X Dentist (Licence: CT 11058) | |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-09-29 |