| NPI | 1255428074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23060) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI022321) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2017-03-09 |