| NPI | 1497912067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02218300) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 049548) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-10-22 |