| NPI | 1679994081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058206-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102557500) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2020-09-10 |