NPI | 1154641785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI02479200) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010576) |
1223G0001X Dentist, General Practice (Licence: NY 055861-1) | |
Enumeration Date | 2010-06-05 |
Last Update Date | 2011-10-24 |