| NPI | 1679026744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI 02647900) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 22194) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |