| NPI | 1609040286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02398000) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054034-1) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2016-05-04 |