NPI | 1679860555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NY 056307) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02502000) |
Enumeration Date | 2011-06-29 |
Last Update Date | 2012-09-20 |