| NPI | 1801136312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 042-6521) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D101710900) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |