| NPI | 1962531053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 044320) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ DI019972) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |