| NPI | 1174937544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02485800) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 057498-1) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2017-05-02 |