| NPI | 1730297417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 049688) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02307900) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |