NPI | 1548479199 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 2065300) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 047784-1) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2011-02-02 |