| NPI | 1346331451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 048689) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102171600) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2010-10-18 |