| NPI | 1023703824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI03114200) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 064055) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2025-09-16 |