| NPI | 1750438776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02322800) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 049646) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 009641) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |