| NPI | 1508060575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE G1-0011504) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02343000) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-03-09 |