| NPI | 1508060666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02175600) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 0511171) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2007-07-08 |