| NPI | 1215239298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02526700) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 055203) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2015-10-08 |