| NPI | 1003098724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02358500) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 051096) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |