NPI | 1962798728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NJ DI02474500) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02474500) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2019-02-19 |