| NPI | 1528254802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009744) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02354600) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2013-05-10 |