| NPI | 1457507840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NY 054745) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: NJ 22DI023412) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2010-04-02 |