| NPI | 1083630222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 1857139) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 17387) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-01-17 |