| NPI | 1659757003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02613400) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030339) |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2015-08-08 |