| NPI | 1356550735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 042409) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI17024) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |