| NPI | 1740779933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 060585) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02743600) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2019-12-02 |