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 |