| NPI | 1457465510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 031756) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 22D101057600) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2018-10-11 |