| NPI | 1063669018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02398100) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054136) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2013-02-05 |