| NPI | 1598247595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02772300) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 12356) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2019-09-25 |