| NPI | 1891960035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 220102435501) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21867) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2010-07-23 |