| 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 |