| NPI | 1922464155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02372800) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 043615-1) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-01-04 |