| NPI | 1942400791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 051945) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 02331100) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2015-08-26 |