| NPI | 1841485125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 051341) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02282200) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2010-01-19 |