| NPI | 1992087068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02478100) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02478100) |
| 1223G0001X Dentist General Practice (Licence: PA DS038761) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2024-06-05 |