| NPI | 1407085186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 63112) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02382800) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2014-08-21 |