| NPI | 1770920084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 22D101745200) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D101745200) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |