NPI | 1093073637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 056838-1) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02671600) |
Enumeration Date | 2012-05-02 |
Last Update Date | 2018-08-02 |