| NPI | 1023265683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02398800) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054090) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2016-12-19 |