| NPI | 1831453877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 50 058683) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02506100) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2016-07-27 |