NPI | 1992304497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02776300) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS042921) |
Enumeration Date | 2020-10-26 |
Last Update Date | 2020-10-26 |