| NPI | 1467788240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 042746) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 10775) |
| 1223G0001X Dentist General Practice (Licence: NJ 22DI01675700) | |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2012-03-30 |