| NPI | 1073831988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054953) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22di02414100) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-07-28 |