| NPI | 1588813810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 054151) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102370600) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2021-10-27 |