| NPI | 1710248026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056879) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22di02532100) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2013-09-30 |