| NPI | 1942467535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 28232) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI23746) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2012-10-11 |