| NPI | 1982001566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6609) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02589600) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2015-07-18 |