| NPI | 1356642276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI02456700) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61066) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2014-01-15 |