| NPI | 1376635946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02264800) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050312-1) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-01-25 |