| NPI | 1225113095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI23235) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-03-21 |