| NPI | 1144219536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02336700) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050756) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2008-09-10 |