| NPI | 1962788091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02485500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI02485500) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2018-12-13 |