| NPI | 1073775334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL dn19277) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02373600) |
| 122300000X Dentist (Licence: NY 053994-1) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2016-06-09 |