| NPI | 1437464633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 055842-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02454500) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2012-03-22 |