| NPI | 1982850947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DIO2430300) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 0540501) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2022-08-09 |