| NPI | 1245648229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02580000) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN20764) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-12-05 |