NPI | 1124349840 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50 057668) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02415000) |
Enumeration Date | 2010-06-16 |
Last Update Date | 2015-04-02 |