| NPI | 1639308927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D102367300) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054976) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2011-05-23 |