| NPI | 1528291689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 14458) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02418900) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2016-04-27 |