| NPI | 1053321430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 048816) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DJ02307100) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |