| NPI | 1588688758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02035300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047504-1) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-03-09 |