| NPI | 1659491967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 010030) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052605) |
| 122300000X Dentist (Licence: NJ 22DI02313000) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2009-08-06 |