| NPI | 1184867343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 009717) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102329700) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |