| NPI | 1679709745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055952) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22di02398500) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2015-07-26 |