| NPI | 1386909992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22di02533400) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856032) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2016-04-13 |