| NPI | 1558465880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 57852) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 049447) |
| 122300000X Dentist (Licence: NJ 22DI02157000) | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2009-02-17 |