| NPI | 1831518331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058164) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22di02606300) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2019-08-28 |