| NPI | 1275871733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056732-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02521700) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-09-02 |