| NPI | 1013301662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 058806) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02642400) |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2022-07-21 |