| NPI | 1982810826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 5563) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040172) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02305500) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-05-06 |