| NPI | 1134312184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 053889-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02289900) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2009-09-25 |