| 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 |