| NPI | 1568651396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 052748) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22d102345900) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |