NPI | 1144423153 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02040200) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 045113) |
Enumeration Date | 2007-06-07 |
Last Update Date | 2007-07-09 |