| NPI | 1437464211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 26220) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02449000) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2020-11-12 |