| NPI | 1669857462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN21260) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02611900) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2016-03-14 |