| NPI | 1427174705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02300500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052175) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2024-10-11 |