| NPI | 1760801971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 057462) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02570000) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-09-10 |