| NPI | 1730443250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02503900) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 056383) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-12-21 |