| NPI | 1497190722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 06832) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NY 060912) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2020-08-07 |