| NPI | 1689980724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 055122) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02454200) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2015-01-27 |