| NPI | 1134112568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22D102272100) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22d102272100) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2017-01-23 |