| NPI | 1376802108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 50056211) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02499100) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2021-12-07 |