| NPI | 1972787059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 052425) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02323600) |
| Enumeration Date | 2007-12-25 |
| Last Update Date | 2007-12-25 |