| NPI | 1982713509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI16306) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS028078L) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2012-05-29 |