| NPI | 1508051467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ DI20476) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 050172-01) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2021-11-08 |