| NPI | 1992040760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS042603) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02510000) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2022-09-27 |