| NPI | 1831361088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053239) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02333400) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2009-08-26 |