| NPI | 1902913783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22227) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050704) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2013-08-28 |