| NPI | 1912248196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056965) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02530100) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-09-09 |