| NPI | 1922334473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 050039) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI101739700) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |