| NPI | 1124237250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI01810300) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 042019) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-03-03 |