| NPI | 1013927813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 052550) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI 023103) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |