| NPI | 1114205382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 0555-771) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02475300) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2014-03-21 |