| NPI | 1265698021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 050450) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02256600) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2009-10-13 |