| NPI | 1720371222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055740) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02470300) |
| 1223G0001X Dentist, General Practice (Licence: CT 010512) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2019-10-08 |