| NPI | 1497923940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02122002) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 21DI02207900) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |