| NPI | 1457447542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22di02307500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050274-1) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-11-25 |