| NPI | 1336387687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054849) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02417600) |
| Enumeration Date | 2009-01-24 |
| Last Update Date | 2011-05-18 |