| NPI | 1649430513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25519) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI2377800) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2010-09-01 |