| NPI | 1053706036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02631600) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 059436) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2018-07-17 |