| NPI | 1871573824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02396500) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21466) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2009-12-30 |