| NPI | 1134453053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22CIO2694100) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 50054694) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2022-09-22 |