| NPI | 1639536402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02610400) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058250) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |