| NPI | 1962662262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 056593) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02408800) |
| 1223G0001X Dentist, General Practice (Licence: PA DS037792) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2017-12-10 |