NPI | 1922194570 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D101529300) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102188601) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22D102203608) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2007-07-09 |