| NPI | 1851601983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 044169) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI01818700) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2017-04-27 |