| NPI | 1689980013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 010876) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22di02445900) |
| 122300000X Dentist (Licence: NJ 25di02445900) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2015-02-03 |