| NPI | 1003221656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02673800) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 058128) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2019-01-16 |