| NPI | 1235448036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 64417) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI02444400) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2015-06-22 |