| NPI | 1760539142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 061051) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02245600) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-07-13 |